Pain practice : the official journal of World Institute of Pain
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Randomized Controlled Trial
Nerve stimulator-guided occipital nerve blockade for postdural puncture headache.
Postdural puncture headache (PDPH) is one of the most common complications of spinal anesthesia, where adequate hydration with bed rest in the horizontal position is the initial recommendation. Epidural blood patch is to date the most effective treatment, but it is an invasive procedure that may result in serious complications. The aim of the current study was to conduct a prospective, randomized, single-blinded comparison between bilateral occipital blockade and conventional expectant therapy in adults suffering from PDPH. ⋯ Visual analog scales were significantly lower in the block group (P < 0.01), and the block group consumed significantly less analgesics in the follow-up period (P < 0.05) compared with control group. Block patients had significantly shorter hospital stays and sick leave periods (P < 0.001). The studied method is superior to expectant conservative therapy in the treatment of patients suffering from PDPH.
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Randomized Controlled Trial
Intermittent wound perfusion for postoperative pain relief following upper abdominal surgery: a surgeon's perspective.
Although there are many methods for postoperative pain management, implementation may be limited in some settings due to practical or financial constraints. Simple, inexpensive and easily implemented analgesic methods may improve access to effective pain relief. ⋯ Intermittent wound perfusion with 0.25% bupivacaine is a safe and efficient method to reduce pain scores and opioid requirement in the early postoperative period. Wound perfusion, however, had no beneficial effect on the postoperative respiratory function.
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Randomized Controlled Trial
Tramadol added to bupivacaine does not prolong analgesia of continuous psoas compartment block.
The primary aim of our study was to evaluate the quality and duration of analgesia when tramadol was added to 0.25% bupivacaine for continuous psoas compartment block (CPCB) using visual analog pain scores. Thirty patients were prospectively randomized into two equal groups (n = 15). ⋯ Success with catheter placement adjacent to the lumbar plexus was 100%, and none of the patients developed any catheter-related complications. In conclusion, tramadol does not provide a clinically significant analgesic action as an adjunct to 0.25% bupivacaine for CPCB.